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Insulin Resistance Test (Best Test for IR & Stubborn Weight Loss) Homa-IR

October 14, 2019

what is the best test for insulin
resistance insulin resistance is linked to the majority of modern disease
obesity diabetes cardiovascular disease all have a component of insulin
resistance so people want to know how to measure it
for a lot of people it’s enough just to measure your basic glucose and maybe an
a1c but for some it’s not enough that’s not going to tell them the whole picture
so today we’re going to talk about Homa IR what it can measure and when it’s a
good idea to ask your doctor for a test coming right up Homa IR stands for homeostatic model
assessment of insulin resistance glucose is one indicator of insulin resistance
but glucose varies it fluctuates a whole lot through the day so depending on when
we catch it we may or may not get a representative value a1c is a blood
glucose average it measures how much glucose sticks to a red blood cell and
the red blood cell lives about three to four months so by measuring how much is
stuck to a red blood cell we can get a three to four month average of the
glucose so that’s a better measurement but it still doesn’t tell us the whole
picture because you could still be insulin resistant and have a normal
blood sugar so let’s talk about that and Homa IR measures insulin and glucose and
the homeostatic means how good is the body’s ability to return to balance
these two factors out to return to homeostasis so we multiply the blood
glucose by the insulin and we divide by a constant to come up with a score so
there’s two factors that drive the score it’s both blood glucose and insulin so
either one could drive up the score and that where it gives us the value so if
you have a normal blood glucose but a high insulin you
still insulin-resistant and if both are high then obviously you are also insulin
resistant so let’s look at a few examples here every time you eat your
body raises blood sugar the food gets into the bloodstream blood sugar goes up
if you eat carbs it goes up a lot if you eat protein it goes up a little
bit and if you eat fat it hardly rises at all then that blood glucose the
purpose is not to be in the blood the blood is just a transportation system to
get the fuel to the cells because the cells are going to do some work with
that fuel and insulin is what allows the glucose to get out of the blood and into
the cell so it’s like a lock key into a lock to open up the door to let the cell
use that fuel so we eat something our glucose goes up insulin goes up it
delivers it to the cell when the cell has the food then insulin is no longer
lead that needed and insulin goes back down so that’s kind of the normal
sequence of things and the system is set up beautifully because it’s self
managing as long as we live a natural life and eat whole healthy foods if we
have a moderate or low amount of blood glucose it doesn’t take much insulin to
control that and we have a balanced a homeostatic situation and our Homa IR
score would be 1 or less so let’s look at a few examples there the first
example is a person who goes get their blood work their fasting glucose is 90
we measure their insulin levels their fasting insulin levels which come out to
4.5 we plug it into the formula we multiply glucose by insulin divided by
the constant and we have 1.0 so this is a person with good insulin sensitivity
meaning it doesn’t take a lot of insulin the body doesn’t have to work very hard
to deliver that food to the cell the cell is receptive it’s sensitive
because it wants that food so this is a good situation there a 1 C measures 5.5
so their average glucose is about 110 and so they start the day off at 90 and
then they eat but they eat reasonably well so the blood sugar goes up it goes
a little bit outside of the zone maybe if they eat some rice and potatoes and
things but it doesn’t climb excessively because they eat whole food and it comes
back down in the range and the body doesn’t have to work very hard the next
example though that person comes in get their blood work their fasting glucose
is 85 so if that was all we measured for that person we go hey congratulations
you’re in tip-top shape don’t worry about a thing just keep doing what
you’re doing and the person goes off and he’s heading into trouble because if we
had also measured insulin we’d see that it was 10 and this person that insulin
is more than twice that one even though they’re fasting glucose is lower so when
we calculate the home IR we get a two point one meaning the body can maintain
the blood sugar especially after a while when you’ve been fasting but it has to
work really hard at doing so then we measure the a1c and we see this person
has a 6.3 indicating an average glucose of 134 and there’s a big big difference
between the fasting the fasting they look good but their average is pretty
high so this person is pre-diabetic and even though if we had sent him off with
the congratulations based on the fasting glucose and he keeps doing what he’s
doing he is heading for diabetes so what is he doing well he starts off the day
low but then he eats his milk and cereal and toast with a jam and orange juice
and then he has a hamburger and a coke and every time he eats his blood sugar
goes very very high it goes way outside that ideal range which is an
emergency and the body has to make a ton of insulin but the body can still keep
up so the insulin is sufficient to bring it back down to a normal level
especially if you let it work overnight which is when we take that fasting
glucose so here’s an example of where you’re developing insulin resistance you
are eating a lot of carbs a lot of processed food the blood sugar goes high
a lot of insulin is pushing all that fuel into the cell and the cell is happy
in the beginning and then after a while it says hey this is too much I can’t use
all this fuel so the sugar gets converted into fat and the fat starts
filling up the cells of the body especially the liver which is usually
the first place to develop insulin resistance the cell has had enough the
cell says I don’t want any more so it starts resisting insulin the longer you
go without food the more the cell can start burning off those stores and then
it welcomes insulin you become more insulin sensitive so this person would
do well to start changing some habits before it’s too late the earlier you can
catch something the quicker and easier it is to turn it around it’s never too
late but this quickly you get at it the
easier it is this is a full-blown type-2 diabetes patients fasting glucose is 200
their insulin is at 20 a 1 C is a 10 average glucose 240 we calculate their
score and it’s a nine point nine so here’s a very insulin resistant person
and of course we had no doubt because every marker indicates that there’s
something out of whack here there if we charted their blood glucose they are
never in the normal range they never ever get down there because they push
their body too far they start off high every meal they eat which is probably
frequent they increase it they make mass of amounts of insulin but the cells are
so resistant that the massive amount of insulin is not can’t make a dent in it
it fluctuates a little bit up and down but it stays at a very high level even
so the moment this person stops eating carbohydrate the blood sugar will start
to go down so there is hope even in this case but what I really wanted to focus
on with the Houma IR is this special case and this is the person who has
tried everything they might have lost some weight
maybe they plateaued maybe nothing happened maybe it’s a person who managed
to lose a good bit of weight but all the remaining weight sits on the midsection
and this could be someone who has eaten really really well for a long time maybe
for years so we checked them their fasting glucose
is a hundred so it’s a little bit on the high end but not alarming we check their
insulin and it’s a whopping twenty it’s it’s as high with half the blood sugar
it’s as high as this one so their score calculates 26.2 so they’re very very
insulin resistant but they’ve eaten well for quite some time so their blood sugar
never goes crazy and we check their a1c it’s a 5.4 their average glucose is
about 108 so there’s hardly any difference between the fasting and the
a1c and in some cases they could be the same this person’s blood sugar never
really budges and yet they can’t lose weight so if we think about this and and
these are these are I have seen people like this and every person with this
might be different so don’t think that I’m just talking about you but it could
be a large range of cases if this doesn’t look exactly like you then just
look at the the principal’s so this person might have been on keto they
might be fully fat adapted the body burns fat for fuel
perfectly they don’t get hungry much they have no cravings but they’re so
insulin resistant that the cells won’t release the fuel okay they have all this
fuel stored on the body but it takes extreme measures to release any of it
the body there’s so much insulin there that the body that that packs the fuel
into the cell that locks the cell down that the body prefers to eat fat to as
opposed to burning it so this person if they’re on keto they probably feel a
strong urge to maintain their calories their intake they get hungry when they
don’t get food because even though their fat adapted and they have all this fat
they still can’t get to it because of all that insulin so in this case you
probably have to get a little bit more drastic so a lot of these people have
already tried the the keto they’ve tried the calorie restrictions they’ve done
all those things so Kido may not be the thing that’s going to do it for them
they it might low-carb is absolutely necessary because if you start loading
up the carbs then their system is going to get even more insulin crazy but keto
may not be enough so they need to stay keto and/or low-carb but they need to
start doing some other things as well exercise would be one thing and they
want to do low intensity exercise something that gets their heart rate to
a hundred hundred and twenty not higher because then you start burning a lot of
cortisol which drives more insulin they might want to play around with fasting
so even if they’ve done intermittent fasting 16 hour fast 18 hour fast they
probably want to go more toward ohm add one meal a day or even longer fasts like
36 48 72 hours and they might be a little uncomfortable because the body is
so resistant to releasing that energy that
fat for fuel but if they can get over the hump then they’ll probably see some
results and then of course then there are also cases where even that may not
be enough because there can be other factors that are underlying the problem
so things like hypothyroid if you’re toxic with metals chemicals immune
toxins or if you have nutritional deficiencies then your body is just not
in a strong enough place to to bounce back all of the things we talked about
are still appropriate but they may not be enough where you may get very slow
results so this is what we specialize at in our office we analyzed the body and
find out what are the hidden root causes so if you’ve tried everything then try
this and then maybe look if there’s someone locally that can help you as
well we do nutrition response testing which is the best method I’ve ever found
of identifying those things so let me know if this answers your questions on
insulin resistance or if there’s anything that you want more clarity on
if you enjoy learning and understanding more than just sort of getting a few
facts bailed out if you feel this is valuable information then make sure that
you subscribe and hit that notification bell also share this information with as
many people as you can because there’s a lot of people out there who need to get
healthy thanks for watching

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  • Reply Dr. Sten Ekberg April 12, 2019 at 4:13 pm

    Learn ways to lower your blood sugars or healthy weight loss

  • Reply Santache Ackon May 20, 2019 at 8:48 am

    Dr. Sten,can an anemic person develop insulin resistance?

  • Reply Rooben Doraisamy May 20, 2019 at 12:56 pm

    Doctor excellent advice I experienced what you presented.

  • Reply Oberon Pan May 20, 2019 at 5:10 pm

    This is absolutely invaluable information I wish I had know 10 years ago. It would have saved me a lot of pain.

  • Reply noor ridha May 21, 2019 at 1:02 am

    very valuable & useful information thanks a lot for your clear nice way of explaining

  • Reply Shenel May 21, 2019 at 4:57 am

    Fascinating lecture. I now have been to confirm I do have insulin resistance! Thank you for this precious info.

  • Reply ichigoo20111 May 22, 2019 at 1:02 pm

    Is post meal glucose test a good test for IR ?
    is normal that you have a rise of blood sugar if you eat a carbs or that is the normal reaction of body ?
    Thank you

  • Reply Joëlle van den Brand May 23, 2019 at 3:42 am

    Dear Sten, I recently discovered your channel! You are amazing. Based on your advice I am taking the blood tests you suggested to understand if I am prediabetic tomorrow. I have been eating low carb since a week. Do you think that this may dilute the test results? E.g. my levels may be better than reality because I have significantly reduced my insulin levels last week. Thanks – appreciate your help!

  • Reply Ten Minute Tokyo 2 May 27, 2019 at 4:04 am


  • Reply Renuka M v May 28, 2019 at 5:25 pm

    Doc my husband is a sports person and has a homa ir of 0.45 and hba1c of 6.. fasting insulin is 3.36.. is it ok ? Please reply.. thank u

  • Reply Renee Slaughter June 8, 2019 at 2:00 pm

    Definitely good information. My doc wouldn't do the fasting insulin test so I paid for it myself. I'm at 11. Fasting blood sugar is 99. So that would put me at 2.6 Not good but I know what to do. And im slowly making progress. Thanks Doc. Keep up the good work!

  • Reply Dorothy B June 9, 2019 at 2:04 pm

    why not use the a1C, seems it would be more accurate a1c*Ins/constant

  • Reply joe zambrano June 11, 2019 at 12:27 am

    I just stop smoking in Dec. And I'm seeing a npd..I'm doing if and taking suplements and eating low carb..what you think about the quitting the that part of the ir, liver enzymes 14 n 16 lds

  • Reply Elisa Frye June 13, 2019 at 4:15 am

    What a wonderful presentation. I’ll be having my first IR measurement tomorrow. Although my fasting and my A-1C are quite good, I feel I cannot be sure how well I am doing until I see my fasting insulin numbers. Your video has provided a clear explanation of exactly what is involved and how and why we, and our doctors can be misled by seemingly-normal BG and A-1C. readings.

  • Reply Sean Fox June 13, 2019 at 1:46 pm

    My name is Sean and my sugar went from A1C went from 8 to probably a five little under five then about an ex because I was eating everything that I should have been eating which is salads and white meats and vegetables and I lost 52 lb of my sugar went down to five or mayo and see what down to a five so I was wondering about four months later I guess I started eating a little starchy foods and my sugar went all the way back up to 10 is there a reason why did that or should I I mean I should have stayed on my died of eating salads and Tina and white meats and stuff I felt better too

  • Reply Red_Queen_of_Shadow-Hunters And_Crows June 14, 2019 at 11:42 pm

    I was told by a doctor that I may have insulin resistance when I was 13 and I think I didn't understand what it meant or the seriousness of the matter and I didn't take it seriously.

  • Reply Ledia Hammond June 15, 2019 at 12:55 am

    What state/city are you located?

  • Reply Aynalem B. June 15, 2019 at 4:24 am

    Do you know the Ethiopian food , It's my traditional dish but I've never heard if it raises insulin, the flour is called "taff" without glutan. I'd love to hear what this what you think , its my dayliy food

  • Reply Jeannette Mondragon June 15, 2019 at 7:44 pm

    Great information, great help, God bless you, Dr Ekberg!

  • Reply James King June 16, 2019 at 4:08 am

    Thank you for explaining the science and the math.

  • Reply Dave Fram June 17, 2019 at 8:06 pm

    Thank you doctor for your videos! Just wondering if you could provide some information on lowering cholesterol ? I'm doing Keto/IF and so far I've lost 20 lbs. I'm 6 ft and 185 lbs so not overweight but my cholesterol is slightly elevated. My doctor suggested I take 10 mg of Crestor and it's lowered my cholesterol but I would love to stop taking a statin if possible. I have no other health issues. Thanks again for all your advice!!

  • Reply Jonathan Jung June 18, 2019 at 4:30 pm

    Thanks Dr. Ekberg. You make everything very clear. My lab doesn't do the HOMA-IR test but they do an insulin test and a glucose plasma and a glucose serum. Should I do the glucose plasma or serum with the insulin test? Thanks

  • Reply k tortora June 19, 2019 at 8:43 pm

    I sent an email to my Primary Care Physician requesting that he order a HOMA-IR test for me. I received this response back from his Nurse Practitioner:
    “I have never heard of this test. I will send an e-consult to your Endocrinologist about it, and get back to you.”
    “I spoke to your Endocrinologist. She notes that the HOMA-IR is for research only and has no application in management of patients. Even with a result, she is not sure what we would do to change or adjust the management of your diabetes.”

    My response: “Okay, I will go elsewhere to get this test.”

  • Reply Manuel Antonio Rivas June 20, 2019 at 1:43 am

    Thank you very much Dr. I will share this video to my friends that have the same problem. Finally I see some information that makes sense to me and my difficulty to loose weight. I recently had a blood analysis done to test my Hba1c, glucose and insuline level. My glucose was 102, Hba1c 5.4 and tne insulin was 22.
    I always measured my glucose levels every day up to 3 times a day. It happens that my fasting glucose is the highest of the day up to 120 some times. But usually in the 100 106 range. After that it goes downto 90 and even after meals it does not rise more than 100. I try to eat a diet very low in carbohydrates. I avoid sugar and all processed food and always skip breakfast, my first meal is at 1 pm and my last meal at 8pm as the latest. I exersice by riding bike for 2 hours at least 3 times from Monday to Friday and on sundays I take a long ride usually 5 hours on hills. But my weight does not move a single pound. I guess I fit in the special case since my HOMA IR is of about 6.5.

  • Reply Leela John June 20, 2019 at 1:13 pm

    How do you measure insulin?

  • Reply Maureen Smith June 20, 2019 at 3:43 pm

    I know I’m number 3. I have been insulin resistant for a long time. I have lost 23 kilos in 18 months, but now have not lost any weight in months. I’ve been doing 18 hours fasts, daily. Eating a meal at 2 pm and 7 pm. Nothing else but water and coffee and tea with cream. I am waiting for bloods that were taken a week ago, had fasting glucose done, but will talk to dr about you’re extra test, see what she says. You make everything sound so clear and easy to understand. Thankyou. I will tell you my numbers when I find out.

  • Reply Matt Reynods June 20, 2019 at 6:20 pm

    I asked my Kaiser Doctor for the HOMA-IR test and he had no idea what that was! He checked with the lab and they also never heard of that test. Scary!!

  • Reply Peepers 47 June 20, 2019 at 8:29 pm

    The best explication in terms easily understood. Thanks!

  • Reply Soteria Charis June 22, 2019 at 1:15 pm

    Are all these tests for A1C, Insulin and FG only done via a doctors orders for bloodwork? It's not something that can be measured at home on an ongoing basis, right? I already check BG and BK at home but I know my "health care provider" would not order any of those tests without reason, unfortunately. The last scenario you mentioned sounded just like me!

  • Reply Tatiane Veloso June 22, 2019 at 4:19 pm

    Hello Dr. Sten. How are you? I'm Tatiane and I'm from Brazil! First of all, I'd really like to thank you for all support and for all important information and enlightenment you have given to us through those spectacular and blessed videos. I have been desperate and since I watched your videos my worries have really reduced! I've been diagnosed with prediabetes and since then it has been a total disarray in my life. I've cried a lot, but now I understood that it is possible that I can lead my body to balance again. The results of my blood test were: a fasting blood sugar level of 83mg/dL, a Glycated hemoglobin (A1C) of 5,7 and an insulin level of 7,30. I'm still afraid of not making those levels lower. I'm already very thin and I'm sad and worried that I'll loose more weight going on the diet that cuts off carbohydrates.
    Do you think it's still possible for me to recover totally from it if I continue on my diet? And once I go down on those levels, will I be able to eat normal food without going prediabetic again ?
    I also have another question: Aproximatelly how long will it take for me to lower that insulin level?
    I really thank you for all! May God bless you!

  • Reply bjorn2fly June 24, 2019 at 7:35 pm

    Must be better to use a OGTT, or, if its normal, a Kraft test.

  • Reply Moy W. June 24, 2019 at 9:37 pm

    Wow! My Homa-IR is 15. My doctor did not explain what it is or what it meant. This video explains a lot. I've tried Keto and lost a few pounds and then stalled. Blood levels only changed a few points. I've recently added IF and will see how much that affects it.

  • Reply Great News June 25, 2019 at 2:53 am

    Hi Dr Ekberg, I searched for HOMA IR under LabCorp, the most popular laboratory used in America and they do not recognize HOMA-IR. What lab has this test? I believe I am one who could benefit from this lab test, as I am not fat-adapted at almost 5 months on KETO diet.

  • Reply b2b atmail July 4, 2019 at 2:33 am

    Best ever explanation seen in any Internet platform. Great job.
    Q. What's are the natural method to reduce insulin?

  • Reply Durvalle Robinson July 5, 2019 at 11:10 pm

    Greetings Dr. Ekberg. I've been doing healthy Keto for 65 days now. I'm a type 2 diabetic. My fasting glucose started out , prior to keto at 250. After Keto it stayed around 80 to 110, the first 4 weeks. The past 3 weeks it's been 100 to 150. I've been on a OMAD schedule. And I work out 30 to 40 minutes every other day. My question is based on something you said in the video. How long is " too long" ??? For insulin resistanc to improve or go away. I thought I was doing well. But now I'm not sure lol. Thank you 😊😊😊

  • Reply Roy VanHess July 8, 2019 at 8:30 pm

    Thank you Dr. Ekberg, makes perfect sense now
    A1C 8.2 in 2013 at age 61, started Metformin

    A1C 7.2 in 2015, added Trulicity injections

    A1C 6.7 in September 2018, I started on a low carb diet after watching Dr. Jason Fung vids

    A1C 5.6 in December 2018, Lost 20 pounds, stopped taking Trulicty

    A1C 6.0 in June 2019, Stalled weight loss at 208, FBG=118 FI=29.9 Calc HOMA-IR 8.7

    Started one meal a day with 16-20 hours fasting a week ago and I’m still mostly showing FBG slightly above 100
    . I plan on adding longer fasting periods after watching your excellent video

  • Reply Alf Free July 9, 2019 at 4:26 pm

    Dr Ekberg,
    I think you should include OGTT test in your hypothetical cases explanation…..And measure blood glucose and the corresponding insulin values at the reference time points.

    Then, it would be more realistic to make suitable assessment.

  • Reply 50CJAZZ July 12, 2019 at 8:35 am

    Thanks for the great information.

  • Reply sue kirsh July 13, 2019 at 12:40 pm

    You described my situation to a t in the very insulin resistant scenario. I lost 40 plus pounds. My belly is still big and I get tired easily and still feel like eating. Getting my first c-peptide test on Monday, and that was a struggle to get, my doc does not think its necessary. I have had one 36 hour fast and it was torture; I was very hungry all the time. I will add more fasts but it's a tough fight.

  • Reply Cliff Graves July 14, 2019 at 6:40 pm

    Hi been watching your videos with great interest. So is it a hopeless case for a would be athlete that is diabetic type 2 to excel in their sport? You mention that aggressive training techniques like intensive weight training might raise cortisol but how can an athlete ever train hard then? Boxers have to train hard so how do they get over this hurdle if they are type 2 diabetic?

  • Reply Aïda Hayes July 15, 2019 at 5:08 pm

    What is frustrating is that my doctor’s office does not know what a HOMA IR test is. All they know of is A1C. I can’t request something they have never heard of. 😖

  • Reply Gnsgrashus July 19, 2019 at 3:34 pm

    Excellent explanation of insulin vs glucose. Thank you so much for making us aware that simply a low glucose reading does not necessarily indicate all is well.

  • Reply Fayhae EL Marrakchi July 20, 2019 at 12:29 pm

    Thank you Doctor, please I have a question: what is the relation between hypothyroid and insulin resistance? Because I think I might be in the case scenario with a normal blood glucose and high I tried almost everything and nothing works ( with exercise and everything) . Do I need a check for my thyroid first or insulin?

  • Reply Van Aser July 22, 2019 at 1:43 pm


  • Reply Shannon Kringen July 23, 2019 at 12:37 am

    thanks for this

  • Reply Liliana Brancato July 24, 2019 at 10:09 am

    Hello doctor Ekberg
    Ever since I'm eating low carb I lost too much weight. Now I'm 40 kilograms for 1,50 meter and even though my blood tests are ok, I don't think I'm in a good shape.. I'm really too much skinny. What can I do to gain a little More weight?

  • Reply Ally Mantikas July 24, 2019 at 10:15 pm

    My a1c is 5.2 and my proinsulin is 1.9 to low ?

  • Reply Christopher Logsdon July 30, 2019 at 8:28 pm

    In the UK none of the medical professions are interested in high insulin annoys me so much my insulin level when fasting is through the roof and they’re not bothered😡😡😡😡😡😡😡😡😡😡😡😡

  • Reply Herb Good July 30, 2019 at 9:07 pm

    Have had my glucose measured, as well as insulin (not specifically for purposes of Homa IR) and glucose measurement is given in Mg/DL while the insulin level given as MCLU/Ml. How to work with those numbers for this measurement? Thanks.

  • Reply Ewelina siemieniuk July 30, 2019 at 10:15 pm

    Great video! Thank you

  • Reply KG August 1, 2019 at 3:15 am

    Really valuable one. Thanks Dr

  • Reply Dave Fiano August 6, 2019 at 9:04 pm

    ? Calculator? Homa-IR calculation is: FGXFI/22.5 = 90×4.5/22.5= 18, not “1.0” as in first example (according to quoted calculation on every other site).

  • Reply Mi la August 7, 2019 at 8:40 am

    Doctor Ekberg, thank you for what you do! I found your channel a couple weeks ago I learn a lot from your videos every day and want to ask something almost after every video. If it is ok I'll ask some questions in the comment under this video because it was the one I saw first and currently most important for me.

    I am 38, height 168 cm, weight 56 kg. I have 2 children. During the 1st pregnancy I was diagnosed with Gestational Diabetes. I guess it happened because I had more than usual stress at that time, I worked from home, didn't do much physical activity because for first 6 months I was nauseous all the time and low energy, didn't want to do anything. And my diet was primarily carbs. After pregnancy the glucose test got back to normal. But I gained weight, about 10kg, in the next 3-6 months. I felt like I was always hungry. Then after 2 years my weight got back to normal, ~58kg. The second pregnancy was easier. I was worried I'll have GD again but this time the glucose test was normal. And I was nauseous and sick only for about 3 months. I heard that if during pregnancy the woman feels sick it means her kidneys are having hard time removing toxins from the body. I don't know for sure if it is true or not but now I plan my next pregnancy and wonder what can I do beforehand to avoid this sickness period at all. If you know anything about it please share.

    Also I still worry about getting GD again. This year I made some changes in my diet: removed all wheat products, sugar/honey/candies and prepackaged granola bars, tried to avoid adding salt. At first I ate a lot of fruit instead of sweets that I removed. After your videos I started to track everything I eat with an app. And made a limit of 150 total carbs. Eating less fruit, more vegetables. After about a week of trying to stay under 150 carbs for a few days I felt tired and nauseous in the morning, noticed my heartbeat more than I normally notice, had some mild leg cramps at night. I read it could be because of low sodium so I started to add a more sodium back. And it seems like it helped me. I haven't got to all your videos yet maybe you could direct me if you already talked about how much salt is recommended on different types of diets.
    A few days ago I asked my doctor to place orders for my blood tests and add Homa-IR. He said he doesn't know this test and I asked if he can order fasting insulin levels test (I thought since the glucose level is something that I can find in A1C test I need only insulin level to calculate HOMA-IR score myself). So in the end the doctor ordered "NMR Lipoprofile with Insulin Resistance Markers without Lipids (without graph)". I'm not sure it is the right test and wanted to check with you before I do it. Maybe you could share a CPT code for the Insulin level test I hope it can also will help explain them what I need. My A1C/Estimated mean glucose in the last 3 years was 4.9/94, 5.0/97, 4.7/88. I want to find out my Homa-IR score to make sure I haven't developed Insulin resistance yet and make other changes to the diet if necessary.

    Thank you again for your help and support!

  • Reply cancanturco August 16, 2019 at 4:11 am

    I weight 172 lbs and my ideal is 167. was concerned that I started to have bigger stomach than Ussual …so, I have 3 days fasting (16 hrs per day) but now I want to know my IR # and I'll probably have to wait until next year to have that test…sad. I guess I will eat only salads and see if the stomac goes down

  • Reply Givepeace Achance August 17, 2019 at 5:40 am

    I'm in the USA, my doctors have never measured my insulin, only blood glucose. I'm sure if i asked them to they would say they have, because they tested blood glucose. They're just pill pushers for every symptom.

  • Reply Laken Conner2 August 18, 2019 at 5:47 am

    Thank you for this! I think I might be that 'special case'. I have never dieted & have been skinny my whole life. 10 years ago while pregnant and addicted to Pepsi was told I had gestational diabetes. I quit the Pepsi, bread and pasta only while pregnant and afterwards went right back to it. I have always eaten one meal a day just because of my work schedule and I would crash immediately after eating.

    I got the Mirena put in 7 1/2 years ago and in the last 5 1/2 years put on close to 50 lbs. I use to always be hot and now I am always cold. I started taking my temp. daily before getting out of bed and found my core temp. running 97 degrees 6 out of 7 days. I was also a smoker for the last 30+ years. I quit smoking March 19, 2019 & knew I did not want to gain anymore weight so I started Keto May 3, 2019. I lost 9 lbs the first 21 days, felt great and had a ton of energy. I started tracking my glucose levels. I am at pre diabetic levels most days. (low 100s 17 hours fasted). I decided to get the Mirena out on June 24, 2019. Even though I'm 49 I am now having a regular period so not in menopause, YET!

    Then all of a sudden my numbers started going the wrong way. I would wake up and weigh in and be up a pound or up 2 pounds. I am swelling up and puffy and my muscles feel so weak sometimes it's hard to lift my legs! And today I step on the scale and I gained another 2 pounds over night and have gained back ALL I lost even though I'm eating 1400 or less calories a day. To the point where some days I feel like I'm starving but I refuse to eat because I want to stay fasted to eat my body fat but it isn't!! UGHHH

    I take Potassium, Magnesium, Calcium, Zinc and salt every day but I'm having bad cramping at night. I do not cheat and most days am under 3% Carbs and around 80% fat.

    Between the quitting smoking, quitting carbs and getting the Mirena out have I just shocked my system too much too fast? Or is something really wrong with me? I can't take the weakness in my muscles anymore!
    Help!!! Thanks!! XO

  • Reply Yyyyui Pch August 19, 2019 at 11:31 am

    What is constant 405 where it come?

  • Reply Grace Siahaya August 20, 2019 at 2:00 am

    Thank you very much Dr. Sten for your explanation on this video about Homa IR… I have learned so much. Usually I only test Fasting Glucose only and A1c… But Now I learned that it is not enough… I still need to do my HOMA IR test. I have a grandfather and mom who has Diabetes type 2 so I am very concerned for my health especially my blood glucose level and insuline level. Last week I tested my fasting insuline and the result is a bit shocking to me. My A1c is 4.7 but my Fasting insuline is pretty high… It is 10.9……dr.Sten…could you please explain what the normal range is for HOMA IR… Is it between 1.0 – 2.0 or is it something else… You have not mention the normal range of HOMA IR yet in your video… Thank you very much

  • Reply YK Chan August 22, 2019 at 4:48 pm

    We know of blood glucose meter and kit.

    Is there anything call – insulin test meter and kit – ?

    How may we assess IR with over the counter tool kit ?

  • Reply Rajesh Garg August 24, 2019 at 11:04 am


  • Reply Vijay More August 26, 2019 at 8:03 am

    Hi Dr. Sten, Thanks for informative video. I have one question. Can you please provide us normal,prediabetic and diabetic range for Homa IR test & A1C test?

  • Reply Jaime Perez August 27, 2019 at 5:47 pm

    Great video. Also, how do you get the A1C average in examples 2 and 3 of (134) & 240?. And finally, what's involved in Nutritional Response Testing?

  • Reply Samar Adel August 27, 2019 at 7:32 pm

    What about a case
    Fasting blood glucose 107
    Fasting insulin 24
    Homa IR 12.5
    What does this result mean ?

  • Reply Kelly Clover August 29, 2019 at 5:43 pm

    Here is a problem I'm tackling. I am significantly overweight and an insulin test I took 3 days ago proved I have insulin resistance. I was at 12.7 on insulin and 92 on blood sugar. Using the formula ( Blood glucose) x (Blood insulin) / 405 = IR I have a figure of 2.88 for IR. Anything over 2.00 is considered unsatisfactory. With a low carb diet that also increases fat I have had some success with weight loss. I am not using any prescription medicine. I have been noticing blood pressure spikes when some weight starts coming off. When my weight is not changing I don't see the spikes. My suspicion is that toxic substances are being released when weight comes off but I'm not sure what to do about it.

  • Reply Pablo Segovia August 29, 2019 at 5:45 pm

    Hi Doc, just a few people amassed me like you, thank you. Can you please make a video on H pylori ?

  • Reply Vicki Edwards August 29, 2019 at 9:28 pm

    I will be asking my primary Dr to do order the MOMA IR test for me… I hope this test will be done. Earlier post you talked about getting the test online perhaps? Can you update this?

  • Reply mamiyapress August 30, 2019 at 9:20 am

    I have been a T2D since 1997 and was put on insulin from day one, I have been to numerous Quacks since with no success and I am suffering because of it. I spent 8 weeks in hospital last year with blood cloths in my leg and my eyesight has begun to fail. My question is; for the last 2 months I have been on omad with very low carbs but my counts continue to be very high 17 in the morning (x18) and 18-20 (x18) in the afternoon before my meal, I take 30 units of insulin at night and 26 units before my meal but this does not lower it more than about 10 (x18) after two hours, what can I do?

  • Reply porkyV2 August 30, 2019 at 12:34 pm

    this explains a lot. thank you so much!

  • Reply sketchart photo August 30, 2019 at 7:48 pm

    explains sooo much!!
    thank you!

  • Reply sketchart photo August 30, 2019 at 7:50 pm

    awesome videos sir.!!
    can you do a video to explain how fat may cause or not cause plaque in the arteries.

  • Reply Inayat Khan August 30, 2019 at 8:00 pm

    wounderfull and new information

  • Reply Dr. Arindam Chattopadhyay August 31, 2019 at 9:34 am

    The insulin measured here is fasting insulin or pp insulin?
    If fasting then after how many hours of fasting?
    If pp then after how many hours of eating?

  • Reply Medi Media August 31, 2019 at 10:46 pm

    so good thank you

  • Reply Library Files September 2, 2019 at 9:46 am

    What is the formula?

  • Reply Graham Edwards September 3, 2019 at 4:46 pm

    I have been trying to improve my wife's IR for a few months now and things are improving slowly.
    My A1c was also nearly pre diabetic. We both did some fasting and my weight came down 10kg fairly quickly. My wife has lost some weight, but needs to lose some more. I am fairly sure that my HOMA IR is now normal, but my wife's remains slightly raised, and we will continue working along the lines that you mentioned.
    Thank you for your videos, they are extremely helpful and not many doctors in England have heard about it either.
    I am a retired GP, and my wife has Altzheimer's.
    We are doing our utmost to reverse the condition. ..
    Elizabeth & Graham, Chichester GB

  • Reply Lilo Emyoung September 4, 2019 at 12:51 am

    I am having strange results with this formula, or I am not understanding if the result is good or bad 🙁
    My FG is 82 my insuline is 1.9 ( lower than the 2.7 threshold) my A1c is 6.3
    So if I apply the formula 82×1.9= 155.80
    155.80 / 405 = 0.38 !!! Anyone please could explain to me this result! Good? Bad ?

    I am turning into a type1 diabetic because of my insuline level (had to force my doctor to check it and she is still refusing to check my C-Peptide!) 😡

  • Reply G Butler September 5, 2019 at 5:55 am

    Is this the same as a fasting insulin test?

  • Reply ankur khurana September 5, 2019 at 11:38 am

    1) FASTING GLUCOSE – 75 mg/dl
    5) HOMA IR INDEX – 0.5
    6) HBA1C – 6.5

    Above values came in my homa ir test, Dr. Please explain me the results, are these ok or not?? If not then what should be the target ??? HELPING ME IN ABOVE TEST WOULD BE HIGHLY APPRECIATED.

  • Reply Oceanic Blues September 5, 2019 at 6:25 pm

    What an incredible, informative and important video. Really awesome. Thanks for educating us. Thank you very much. Cheers from Mumbai. Delilah

  • Reply Patrick B September 6, 2019 at 6:19 pm

    Excellent explanation, thank you so much!

  • Reply LD September 7, 2019 at 2:25 am

    Very well explained. Keep it up!

  • Reply Luc Vileyn September 7, 2019 at 12:48 pm

    Hi Dr. Ekberg, thank you for your great videos. My fasting glucose is 134. insulin 6.95 and A1C 5.3. So homa-ir is 2,3. bmi is 22. I'm not on diabetes meds. Could you give some comment on those numbers? Could you also do a video on HOMA-B? Thank you.

  • Reply pilgrim985 September 8, 2019 at 6:32 am

    I love how though you are! Thanks!

  • Reply JMT September 9, 2019 at 11:02 pm

    NEVER too late to learn something new ( unless you’re dead). I’m 72 and I guess I’m a late learner, but not too late. I’m requesting this test on my own. my local lab charges $59. Well worth the money. My PC orders basic panels at my yearly, but I’m not so sure my insurance would cover it and I’m not waiting for 6 months. Thank you DR for all your information.

  • Reply Adaja Palmer September 10, 2019 at 5:36 am

    Yuh da truth

  • Reply Xmystic811 September 10, 2019 at 4:42 pm

    My Endocrinologist says the homa-ir is not commercially available, only research. Is this so? If not what is the test number for the lab?

  • Reply Srini Bhavani September 11, 2019 at 8:18 am

    Hi Dr. Ekberg, every single video you have put out, gets all of us to understand so much and to gain a TON of knowledge. Thank you VERY MUCH!!!

    Regarding HOMA-IR, I have a couple of questions, please.

    1) Could you please confirm the units used. For the Blood Glucose, I think mg/dL is used. Not sure for Insulin level, what units are being used in the above formula for calculating IR.

    2) Also, how different would the HOMA-IR with the C-Peptide level be, when compared to using Insulin levels.

    My understanding is that C-Peptide gets released at the same time as Insulin, and in Quantities similar to Insulin. However, C-Peptide stays on far longer than does Insulin. So, would you say, using capturing C-Peptide levels is better for measuring IR?

    Also, does it matter when we measure BG and corresponding C-Peptide values? Almost always, it seems to be that the Fasting BG and C-Peptide levels (levels measure after about 8-12 hours of Fasting), are being used. Could this be done Postprandial for instance?…measuring BG and C-Peptide levels about an hour or hour and a half, after lunch maybe… Would that be any different or better….for measuring IR?

    Thank you so much, in advance.

  • Reply Linda McNeil September 15, 2019 at 10:37 am

    Nailed it!

  • Reply Grant Shramek September 17, 2019 at 3:55 pm

    Eat 20 carbs a day or less, High-quality fat With a little Animal protein until you are satisfied No more than twice a day. This one sentence If followed Will do you more good than any medication you could ever get.

  • Reply Lucita C September 18, 2019 at 10:43 pm

    Dr Sten. I finally did the insulin, A1C and glucose to find out if I was insulin resistant. I got glucose of 79, A1C of 5.1 and insulin of 2.1. My HOMA would be 0.41. Watching your video and the normal ranges I found that my insulin and HOMA are lower than your suggested range. It is that bad or good? Thanks a lot. I hope you can give me your advice

  • Reply Vijai Moorthy September 19, 2019 at 9:41 am

    Dear Dr.Ekberg – I follow your channel and am appreciative of knowledge you impart in videos. I share them with my friends and relatives. During one of the conversations, I came across a relative of mine who has the condition known as "Reactive hypoglycemia" and I had not come across any videos addressing this topic. If you can address this in one of your forthcoming videos covering details of this condition and advice for such persons regarding intermittent fasting, type of diet, frequency of food intake, etc…

  • Reply Jerry WineBrenner September 20, 2019 at 8:31 am

    OK, I should know better. I am working to OMAD and making that a low carb meal. This HOMA IR test has opened my eyes. A score of 14.69 is way to much. To have a way to calculate our level of insulin resistance. My health care provider has no problem ordering my fasting insulin test so my insurance pays for it. I am diabetic and am already to get all of the other glucose numbers. This equation is awesome and so are you Dr. Ekberg! Thank you. P.S. I am also using your GKI calculations.. More awesomeness.. LOL

  • Reply John Eli September 21, 2019 at 10:13 pm

    If my fasting glucose and A1c is normal (89, 5.4), would that be an indication that my insulin levels are normal too? Just wondering if there is any benefit in getting this test for my situation

  • Reply wod wod September 22, 2019 at 4:32 am

    The last category is where I am at now or so I believe. I am low income, age 54, female, have medical. Had gastric sleeve surgery Jan.2018, was 293 and 9 months ago last weighed at 237pounds. Haven't done any follow up since. Where do I restart having Medical? I live in zip code 92805. Please help. Thank you

  • Reply Brit Reed September 22, 2019 at 4:54 pm

    You are awesome!
    Keep up the great work!!

  • Reply لا اله الا الله استغفر الله September 23, 2019 at 10:13 pm

    Is insulin resistance the same as diabetes type 2 or is it an indication to pre diabetes?

  • Reply Patricia Bailey September 24, 2019 at 9:40 pm

    I love your videos. Where do you get a Home-IR test. Do most doctors consent when asked? Is it expensive?

  • Reply Ayesha Ali September 30, 2019 at 12:57 am

    those doctors who dont havee ideea on homo-ir, make them do ffasting glucose and insulin, put theem in homo-ir formula

  • Reply Ken Taylor October 7, 2019 at 10:35 pm

    I'm learning more than I imagined I would.

  • Reply Carol Dees October 8, 2019 at 5:48 am

    Great video! I'm just like the last example! I've been keto 4+ years, no weight loss in 2 years. I keep trying to find the secret. I eat 2 meals a day!

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